Suchergebnisse

This report addresses strategies and treatments found to help in addressing the harmful use of alcohol in Aboriginal and Torres Strait Islander communities. Foreword The consumption of alcohol at high risk levels is a national issue, however, the focus of this inquiry is the harmful use of alcohol in Aboriginal and Torres Strait Islander communities. Many reports and studies have recommended stemming the flow of alcohol to address the problems, but usually these works do not analyse why a person drinks at levels which cause them and their loved ones harm. The social and economic determinants of harmful alcohol use such as unemployment, poor housing, racism, trauma, poor education and peer pressure mean that Aboriginal and Torres Strait Islander communities are overly impacted by the harm caused by alcohol consumed at high levels. A recent Amnesty reports note that it costs $440,000 per year to keep one young person in detention in Australia. This report recommends that justice reinvestment strategies should redirect these resources to overcoming the deprivation and despair in so many Aboriginal and Torres Strait Islander communities. This report addresses strategies and treatments found to help in addressing the harmful use of alcohol. Community led solutions are always the key to uptake and success. Unfortunately slow government processes, for example approving community produced alcohol management plans and the short length of project funding often frustrates community initiatives. The magnitude of the problem caused by high risk consumption of alcohol is often hidden by the lack of collection of useful data for example at the time of hospital admissions, when children are put into out of home care because of their neglect, when people are incarcerated because of alcohol related crime and when children are born with Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Spectrum Disorder (FASD) at some of the highest rates in the world. The committee found examples of the world's best practice at places like Groote ...

Objectives Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. Methods PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population's SSB consumption or an intervention that focused on reducing SSB consumption in this population. Design Systematic scoping review. Results 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy). Conclusions There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed. ; Kathleen M Wright, Joanne Dono, Aimee L Brownbill, Odette Pearson, nee Gibson, Jacqueline Bowden, Thomas P Wycherley, Wendy Keech, Kerin O'Dea, David Roder, Jodie C Avery, Caroline L Miller

OBJECTIVES: Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. METHODS: PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population's SSB consumption or an intervention that focused on reducing SSB consumption in this population. DESIGN: Systematic scoping review. RESULTS: 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy). CONCLUSIONS: There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from ...

Background: Smoking prevalence remains high in Aboriginal and Torres Strait Islander Peoples. Indigenous peoples in countries colonised by Western nations prefer culturally-targeted anti-tobacco messages, yet only recently have messages been tailored for Australian Aboriginal and Torres Strait Islander Peoples. We conducted a national survey to determine how messages are being developed for Indigenous tobacco control. Method: Forty-seven telephone interviews were conducted with 44 of 53 eligible organisations. Twenty-two Aboriginal Medical Services (AMSs), 13 Government Organisations (GOs), four Universities and eight non-government organisations (NGOs) participated. Questions included targeting and theoretical approaches, community consultation, messages types and design, campaign types, cultural challenges, recommended actions, resources developed, pre-tests and evaluation. Findings: Responses were scored according to core components, and message features. Total scores (mean 10.9 ±SD 2.7) were not associated with organisation type. A community-orientated, bottom-up approach was popular (47%), 55% used a theoretical framework, 87% used a positive benefit appeal; 38% used threat messages, 72% conducted a pre-test and 53% evaluated programs. Cultural sensitivity for message development was divided into superficial (images, language, demographics) and deep structure (socio-cultural). AMSs were significantly more likely to report using more deep structures in message tailoring than NGOs (p<.05) and GOs (p<0.05). A non-linear principal component analysis revealed two dimensions accounting for 53% of the variation in findings. These dimensions were called "cultural understanding" and "rigour". Over 50% of the organisations had experienced cultural challenges in message development included issues raised due to the diversity of Aboriginal and/or Torres Strait Islander cultures for example with the use of Indigenous artwork, language, and stereotypes. Conflicts and delays caused some issues with program management; and the choice and use of role models was sometimes problematic. Conclusion: Features associated with successful anti-tobacco campaigns are reported by organisations Australia-wide for Aboriginal and Torres Strait Islander communities. This study has provided new insight into the current development of anti-tobacco messages in Australia by coupling the use of both cultural understanding and rigour to enable the growth of evidence based practice. Ideally tailoring should include theoretical, behavioural and cultural aspects with Indigenous advisors, to effect cessation. Superficial structures assist message 'fit'. Deep structures, significantly used by AMSs, are centrally processed and influence message salience. We recommend refinement of evaluation, pre-empting cultural challenges, and synergy by partnerships to achieve the goal of closing the gap on Indigenous health caused by tobacco smoking.

The aims of National Disability Insurance Scheme (NDIS) are to provide long‐term, person‐centred care and support to all Australians with a significant and ongoing disability, including individuals with an acquired brain injury (ABI). The scheme has significant potential to provide equitable opportunity of access to health and disability services. Historically, however, service provision in remote and outer regional areas of Australia lags behind more densely populated centres. Aboriginal and Torres Strait Islanders living with disability are already significantly marginalised. Further to this, people with an ABI are very often misunderstood and overlooked by disability services, health professionals and governments, and frequently fall victim to the criminal justice system. This paper provides an overview of the state of ABI disability for Aboriginal and Torres Strait Islanders in remote and outer regional settings, and the present sets of barriers they face to obtaining quality care and effective interventions. A significant opportunity has emerged with the advent of the NDIS but equitable benefit can only be achieved if additional and specialised measures are devised and implemented to appropriately screen for, and assess, incidence of ABI; disability services are appropriately resourced to overcome the pre‐existing disadvantage, and education, training and recruitment of Aboriginal and Torres Strait Islanders with the NDIS is undertaken to lead attitudinal changes in community to disability and health services. This paper concludes with recommendations for the NDIS to meet its laudable objectives.

Since 2006, the 'closing the gap' campaign has been pursued in collaboration between government and health, welfare and rights agencies to close the health and life expectancy gap between Indigenous and non-Indigenous Australians within a generation. This book evaluates the uneven progress being made towards closing the gap. How can Indigenous outcomes be improved across a range of key social and economic determinants of health and wellbeing? Also includes: worksheets and activities, fast facts, glossary, web links, index

Since 2006, the 'closing the gap' campaign has been pursued in collaboration between government and health, welfare and rights agencies to close the health and life expectancy gap between Indigenous and non-Indigenous Australians within a generation. The health disadvantages experienced by Indigenous Australians are shaped by history and the broader social and economic conditions in which they live; progress has been slow and mixed. This book evaluates the uneven progress being made towards closing the gap. How can Indigenous outcomes be improved across a range of key social and economic determinants of health and wellbeing? Also includes: worksheets and activities, fast facts, glossary, web links, index. Titles in the Issues in Society series are individual resource books which provide an overview on a specific subject comprised of facts and opinions. The information in this resource book is not from any single author, publication or organisation. The unique value of the Issues in Society series lies in its diversity of content and perspectives. The content comes from a wide variety of sources and includes: newspaper reports and opinion pieces, website fact sheets, magazine and journal articles, statistics and surveys, government reports, and literature from special interest groups.

Objective: To analyse the implicit discourses within the COVID-19 policy response for Aboriginal and Torres Strait Islander remote communities. Method: This paper uses Bacchi's 'What is the Problem Represented to Be' framework to analyse the Emergency Requirements for Remote Communities Determination under Subsection 477(1) of the Biosecurity Act 2015 (Cth). Results: Despite the leadership of community-controlled health services and regional councils, and the actions of Aboriginal and Torres Strait Islander communities, the policy response constructs Aboriginal and Torres Strait Islander people as vulnerable and mobility as a problem that needs a law and order response. Conclusions: The policy response perpetuates an ongoing paternalistic discourse where Aboriginal and Torres Strait Islander people must be controlled for the sake of their health, informed by notions of Indigeneity as deficient. This stands in contrast with the work of community-controlled health organisations, advocacy by Aboriginal and Torres Strait Islander people for and against restrictions, and examples of communities protecting themselves. Implications for public health: Unilateral government intervention creates limiting discourses of Aboriginal and Torres Strait Islander people. In contrast, ongoing COVID-19 responses can build on the strengths of and work done by Aboriginal and Torres Strait Islander families, leaders, and communities.

Objective: To analyse the implicit discourses within the COVID‐19 policy response for Aboriginal and Torres Strait Islander remote communities. Method: This paper uses Bacchi's 'What is the Problem Represented to Be' framework to analyse the Emergency Requirements for Remote Communities Determination under Subsection 477(1) of the Biosecurity Act 2015 (Cth). Results: Despite the leadership of community‐controlled health services and regional councils, and the actions of Aboriginal and Torres Strait Islander communities, the policy response constructs Aboriginal and Torres Strait Islander people as vulnerable and mobility as a problem that needs a law and order response. Conclusions: The policy response perpetuates an ongoing paternalistic discourse where Aboriginal and Torres Strait Islander people must be controlled for the sake of their health, informed by notions of Indigeneity as deficient. This stands in contrast with the work of community‐controlled health organisations, advocacy by Aboriginal and Torres Strait Islander people for and against restrictions, and examples of communities protecting themselves. Implications for public health: Unilateral government intervention creates limiting discourses of Aboriginal and Torres Strait Islander people. In contrast, ongoing COVID‐19 responses can build on the strengths of and work done by Aboriginal and Torres Strait Islander families, leaders, and communities.

Objective: To create supportive environments to reduce sugary drink consumption and increase water consumption by partnering with remote Aboriginal and Torres Strait Islander communities in Cape York. Methods: This paper applied qualitative and quantitative methods to evaluate a co-designed multi-strategy health promotion initiative, implemented over 12 months from 2017 to 2018. Outcome measures included changes in community readiness, awareness of the social marketing campaign and changes in drink availability. Changes in store drink sales were measured in one community and compared to sales in a control store. Results: Community readiness to address sugary drink consumption increased in two of the three communities. Awareness of social marketing campaign messaging was high (56–94%). Availability of drinking water increased in all communities. Water sales as a proportion of total drink volume sales increased by 3.1% (p<0.001) while sugary drink volume sales decreased by 3.4% (p<0.001). Conclusions: A multi-component strategy with strong engagement from local government, community leaders and the wider community was associated with positive changes in community readiness, drink availability and sales. Implications for public health: Partnering with community leaders in the co-design of strategies to create environments that support healthy drink consumption can stimulate local action and may positively affect drink consumption.

Australians turn to the mainstream media to gain information, analysisand reasoning about events and issues on a daily basis. 'The news' has apowerful and permeating influence on how we all understand and make sense of the world around us. Notions of 'objectivity' and 'fact' in media traditionbelie the reality that the experiences and values of those who work in the media influence the way events and issues are portrayed. Like many Australians, those who work in the media may have ill-informed or prejudiced views of the historical and current experience of Aboriginal and Torres Strait Islander communities. Although there are many commentators, opinion columnists andothers who make overtly racist statements about Indigenous people, racism in the media also manifests in more subtle ways in everyday media practices of news gathering and the narrative structures of news reportage. There is an institutional racism in the media, an entrenched culture that represents issues and people in particular ways. It is as much about what is not reported as what is. Whether deliberate or unconscious, those working in the media have the power to marginalise and construct Indigenous communities as 'other', as associated with criminality or conflict. This power comes from the capacity to make connections, to represent events or issues in the context of pre-existing prejudices. This article explores the relationship between media reporting, political rhetoric and community attitudes, and the impact on Aboriginal andTorres Strait Islander people - from the way that legislation and policiesconcerning Indigenous people are formulated, to the way that Indigenouspeople are treated on a daily basis in the street, in the workplace, at school, and in the community.